Offer The Option of Medicare For Everyone

October 21, 2009 — Ron Chusid

I’ve always thought it was a mistake to include calls for a “public option” in health care reform. I don’t mean the concept of a public option, but the name. The public has been easily mislead about what this actually means. Many even believe that it means they will have to pay for it out of their taxes, in addition to paying insurance premiums, when actually the public option will be financed by premiums from those who voluntarily choose it.

The public option is modeled after Medicare, which is an extremely popular program. Polls have shown that Medicare beneficiaries are more satisfied than those in employer-provided health plans. An irony of the health care debate is that Republicans have conned many seniors to protest against the government messing with their Medicare. Using the example of Medicare is helpful to debunk the conservative meme that government programs never work, with Medicare providing health care to beneficiaries more efficiently than the private insurance industry does.

The public option already does well in most polls. A Washington Post-ABC poll published Tuesday showed 57 percent of the public supports the public option while 40 percent oppose it. Still, it doesn’t hurt to improve popular support even further by stressing the similarity to Medicare. House Democrats are nowtalking of rebranding the program as Medicare E–Medicare for everyone.

This might simply amount to renaming the public option, but other ideas involving Medicare have been around for a long time. Many advocates of a single payer plan have argued that the simplest way to do this would be to go to Medicare for All. Expanding Medicare has often been a part of more conservative efforts at health care reform. As it is typically those approaching Medicare age who have the hardest time purchasing insurance on the individual market, one solution (short of comprehensive health care reform) might to be to allow people at age 50 or 55 buy into Medicare. A public option modeled after Medicare would provide the same benefits without the age restrictions.

7 Comments

I am a major booster of ‘Medicare for All’ as I’ve always thought it offered the smoothest and least traumatic transition to a single payer system. And, honestly, Teddy Kennedy’s original bill is still bopping around Senate subcommittees. It would not be a horrible ordeal to put it on the table, since Republicans are not touching reform more to their liking anyway.

And honestly, ‘politicizing Kennedy’s death’ or not, I can’t think of a better honor to the man than finally passing Medicare For All.

Of course Medicare recipients are satisfied with their care. Their premiums are lower than private insurance because the government sets the reimbursement rate for doctors lower than the cost to deliver those services. As a result, hospital administrations are forced to recoup the losses by charging private insurers more for the services. All of the talk about fair competition created by a public option is a myth. Private industry can not compete with government price fixing. The public option will bankrupt private insurance leading to the single payer health care system liberals want so badly. However without private insurance to subsidize the lower reimbursement rates, government health care will be forced to either raise premiums or ration care.

Your argument might have made sense 15 years ago but is seriously out of date. Private industry has copied Medicare in fixing prices. At present Medicare is one of my best payers. Their fee schedule is slightly (and only slightly) behind private insurance companies. As Medicare requires less office overhead to deal with than many private plans, and pays more reliably, overall they come out ahead of most private payers.

The Congressional Budget Office has looked at the question of whether the public option would bankrupt private plans. They found that only a small percentage of people would wind up in the public option (partially as most people wouldn’t even be eligible to choose it). Health care reform will result in more people being covered by private insurance than is the case now.

Disclaimer-Coming straight from right wing echo chamber- I’m told that while the government can make citizens pay taxes, it can’t Constitutionally require people to have insurance. I don’t know if the “Final Bill” will have penalties for people opting not to purchase insurance or not, but do you think requiring people to have health insurance would pass constitutional muster? (I honestly don’t know what part of the constitution it would alledgely violate, other than the enumerated powers clause which seems to me that that ship has sailed a long time ago.)

There is no truth to the claims that an insurance mandate is Un-Constitutional. I’ve even seen some of the more serious conservative legal bloggers debunk this claim from the right.

At this point it isn’t certain but the trend recently seems to be to keep the mandate but water it down. It is all speculative as we don’t have the final legislation, but the latest gusstimate I saw earlier this week is that the penalty for not having coverage would take several years to even reach a $750 per year (plus many would be able to opt out if they could show that purchasing insurance would be a financial burden). Keep in mind that it is the insurance industry which is pushing the most for a tougher mandate.

I’m against Socialized government anything. I want small government, not monstrous entities. My government, which is through my consent doesn’t tell me what to buy, think, or do. It bows to the one from which it gets it’s temporary power. And I have more than words with which to back this up. Know what I mean?

Rather than just focusing on the size of government you should also look at the power of others, such as insurance companies. This bill essentially protects us against abuses of the insurance companies rather than telling you what to buy, think, or do. You will even have more choices as to what type of insurance to buy. (On the other hand, it you just want to be a free rider and pass your health costs onto others by going without insurance then your choices will be reduced.)